28 December 2018 (Friday) - What If...

Here’s an interesting case that appeared on the Facebook Blood Bank Interest Group today:

"Ante-natal patient, 38 weeks gestation, Caesarean section planned. 2 units requested for mum to cover - timescale is 2-3 hours. Antibody screen was negative at 28 weeks, at which point 1500iu prophylactic anti-D was given, but now weakly positive antibody screen with R2R2 cell. Antibody ID shows the following;
Anti-D (weak by IAT, stronger by enzymes)
Anti-c (enzyme only)

What blood are you issuing?"

The subsequent discussion was interesting. Clearly we have a patient who is A Rh(D) Negative with anti-c. Obviously you give them blood which is both D-Neg and c-Neg…
In theory.
In practice r’r’ is only about 0.01% of the population…

Given two hours I would throw it at NHSBT and the consultant… and hope no blood is needed.

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